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Background Multisystem inflammatory syndrome in adults (MIS-A) is a severe condition temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods In this retrospective cohort study, we applied the US Centers for Disease Control and Prevention (CDC) case definition to identify diagnosed and undiagnosed MIS-A cases among adults discharged during April 2020–January 2021 from 4 Atlanta, Georgia hospitals affiliated with a single medical center. Non–MIS-A coronavirus disease 2019 (COVID-19) hospitalizations were identified using International Classification of Diseases, Tenth Revision, Clinical Modification encounter code U07.1. We calculated the ratio of MIS-A to COVID-19 hospitalizations, compared demographic characteristics of the 2 cohorts, and described clinical characteristics of MIS-A patients. Results We identified 11 MIS-A cases, none of which were diagnosed by the treatment team, and 5755 COVID-19 hospitalizations (ratio 1:523). Compared with patients with COVID-19, patients with MIS-A were more likely to be younger than 50 years (72.7% vs 26.1%, P <.01) and to be non-Hispanic Black (81.8% vs 50.0%, P =.04). Ten patients with MIS-A (90.9%) had at least 1 underlying medical condition. Two MIS-A patients (18.2%) had a previous episode of laboratory-confirmed COVID-19, occurring 37 and 55 days prior to admission. All MIS-A patients developed left ventricular systolic dysfunction. None had documented mucocutaneous involvement. All required intensive care, all received systemic corticosteroids, 8 (72.7%) required mechanical ventilation, 2 (18.2%) required mechanical cardiovascular circulatory support, and none received intravenous immunoglobulin. Two (18.2%) died or were discharged to hospice. Conclusions MIS-A is a severe but likely underrecognized complication of SARS-CoV-2 infection. Improved recognition of MIS-A is needed to quantify its burden and identify populations at highest risk. [ABSTRACT FROM AUTHOR]

Greenway is an important linear public space that meets the diverse needs of the public. With the increasing popularity of greenway construction, the study of different greenway usage behavior in different socio-economic areas is of great value to the detailed design and construction of greenway in the future. Using the theory of environment-behavior studies (EBS), this study selected representative urban greenways and suburban greenways in Beijing, China, and conducted a questionnaire survey. Descriptive statistics and the chi-squared test are used to quantitatively analyze and summarize the behavior of greenway users. It is found that user gender, educational level, and residence (i.e., permanent resident or visitor), as well as season of use, are highly similar for urban greenways and suburban greenways in Beijing. However, due to a close relationship with urban location, modified by temporal, spatial, and personal factors, different behavioral characteristics are evident as follows: (1) Urban greenways are most closely related to daily life, work and education of urban residents, with short travel distances, short single use time, high frequency of use, high social and cultural value, wide distribution of age groups and wide distribution of time periods of use. (2) Suburban greenways are an important choice for residents' outdoor activities on weekends and holidays. It is mainly used for ecological protection and sightseeing, supplemented by sports and fitness functions. It has the characteristics of low use frequency, high income level, wide distribution of time and distance, mainly used by young and middle-aged people, and used for a single time of more than 1 hour. Natural scenery along the trail is the most important attraction factor, and waterfront space and walking space are the main use behavior characteristics. [ABSTRACT FROM AUTHOR]

Aim: The changes in body composition and biomarker levels that occur during the aging process are complex and remain poorly understood. The present study aimed to evaluate changes in serum C-peptide levels and fat mass-tolean mass ratio (FM/LM ratio) with increasing age, and to explore the associations between serum C-peptide levels and FM/LM ratio. Methods: This was a population-based cross-sectional study that included 3912 participants aged 30-85 years. Body composition was measured using dual-energy X-ray absorptiometry. Analysis of covariance was used to evaluate how the serum C-peptide level and FM/LM ratio change with increasing age, as well as how the FM/LM ratio changes in line with increasing serum C-peptide level. A multiple linear regression analysis was carried out to determine the association between serum C-peptide level and FM/LM ratio. Results: Analysis of covariance showed that serum C-peptide levels, and most regional FM/LM ratios tended to increase in line with increasing age. Total fat mass, total lean mass, percentage total fat mass and total FM/LM ratio were significantly elevated, and percentage total lean mass decreased significantly with increasing serum C-peptide levels in both men and women. Multiple linear regression analysis showed that serum C-peptide level was strongly associated with the total FM/LM ratio. Conclusions: The findings showed that both serum C-peptide level and FM/LM ratio increased with increasing age, and the serum C-peptide level was closely associated with changes in the total FM/LM ratio. [ABSTRACT FROM AUTHOR]